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Differences in Anatomic Adaptation and Injury Patterns Related to Valgus Extension Overload in Overhead Throwing

Kathryn J Stevens1, Akshay S Chaudhari1, Karin J Kuhn2

  • 1Department of Radiology, Stanford University Medical Center, Palo Alto, CA 94304, USA.

Diagnostics (Basel, Switzerland)
|January 26, 2024
PubMed
Summary

Overhead throwing athletes show distinct elbow adaptations and injuries due to valgus extension overload (VEO). Adolescent athletes experience more bone stress, while older athletes have more soft tissue injuries.

Keywords:
baseballlateral compression forcesposteromedial shearsubchondral sclerosisthrowing athleteulnar collateral ligamentvalgus extension overloadvalgus instability

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Radiology

Background:

  • Overhead throwing athletes are susceptible to elbow injuries from valgus extension overload (VEO).
  • Understanding age-related differences in adaptive changes and injury patterns is crucial for prevention and management.

Purpose of the Study:

  • To investigate age-specific adaptive and injury patterns in the elbow among overhead throwing athletes with VEO.
  • To compare these patterns between athletes and controls, and across different age groups.

Main Methods:

  • MRI or MR arthrography (MRA) of the elbow was performed on 86 throwing athletes and 23 controls.
  • Athletes were categorized into three age groups: ≤16, 17-19, and ≥20 years.
  • Measurements included ulnar collateral ligament (UCL) thickness and subchondral sclerosis at key elbow structures.

Main Results:

  • Adolescent athletes (≤16 years) showed a higher incidence of apophyseal and stress injuries.
  • Older athletes (≥20 years) exhibited an increased rate of soft tissue injuries.
  • Early adaptive and degenerative changes were prevalent across all age groups.
  • Significant differences in UCL thickness and subchondral sclerosis were found between athletes and controls, and varied by age group.

Conclusions:

  • Overhead throwing athletes exhibit unique elbow adaptations and injury profiles related to VEO, differing by age.
  • Age-specific patterns of bone and soft tissue changes highlight the need for tailored injury prevention strategies.